知柏地黄丸联合醋酸亮丙瑞林治疗儿童中枢性性早熟的疗效及血清神经激肽B、脂联素水平变化  

Efficacy of Zhibai Dihuang Pill Combined with Leuprorelin Acetate in the Treatment of Children with Central Precocious Puberty and Changes of Serum Neurokinin B and Adiponectin Levels

作　　者：徐荣荣 杨丽娜 李瑞士[1] XU Rong-rong;YANG Li-na;LI Rui-shi(Ward 3,Department of Pediatrics,Puyang People's Hospital,Puyang 457000,China)

机构地区：[1]濮阳市人民医院儿科三病区,濮阳457000

出　　处：《中国合理用药探索》2023年第7期68-74,共7页Chinese Journal of Rational Drug Use

基　　金：2019年度河南省医学科技攻关计划联合共建项目(LHGJ20190349)。

摘　　要：目的:探究知柏地黄丸联合醋酸亮丙瑞林治疗儿童中枢性性早熟(CPP)的疗效及对血清神经激肽B(NKB)、脂联素(ADPN)等指标的影响。方法:选取2020年6月~2022年1月某院收治的100例CPP女性患儿为研究对象,采用随机数字表法分为对照组与观察组,各50例。对照组给予醋酸亮丙瑞林,观察组在对照组治疗基础上加用知柏地黄丸,两组均治疗6个月。比较两组临床疗效、不良反应发生情况以及治疗前后卵巢/子宫容积、卵泡直径、性激素指标[雌二醇(E_(2))、卵泡刺激素(FSH)、黄体生成激素(LH)]、血清NKB、ADPN、胰岛素样生长因子-1(IGF-1)水平,并测量体重指数(BMI)与骨龄指数(BAI)。结果:观察组治疗总有效率(94.00%)高于对照组(80.00%,P<0.05)。与治疗前相比,两组治疗后卵巢/子宫容积、卵泡直径、E_(2)、FSH、LH、IGF-1水平及BAI均下降,且观察组低于对照组(P<0.05)。治疗后,观察组NKB水平低于对照组(P<0.05),ADPN水平高于对照组(P<0.05)。两组不良反应发生率比较无统计学差异(P>0.05)。结论:知柏地黄丸联合醋酸亮丙瑞林治疗儿童CPP安全有效,能明显抑制骨龄增长速度,其机制可能与改善性激素、降低血清NKB、提高ADPN水平有关。Objective:To explore the efficacy of Zhibai Dihuang pill combined with leuprorelin acetate in the treatment of central precocious puberty(CPP)in children and the effect on serum neurokinin B(NKB),adiponectin(ADPN)and other related indexes.Methods:100 children with CPP admitted to our hospital from June 2020 to January 2022 were selected as the study subjects,and were divided into the control group and the observation group by the randomazation method,with 50 patients in each group.The control group was given leuprorelin acetate,and the observation group was given Zhibai Dihuang pill on the basis of the control group.Both groups were treated for 6 months.The clinical efficacy,occurrence of adverse reactions were compared between the two groups,and ovarian/uterine volume,follicular diameter,levels of sex hormones[estradiol(E_(2)),follicular stimulating hormone(FSH),luteinizing hormone(LH)],serum NKB,ADPN,insulin-like growth factor-1(IGF-1)before and after treatment were compared between the two groups.Body mass index(BMI)and bone age index(BAI)were measured.Results:The overall efficacy rate in the observation group was 94.00%,which was significantly higher than 80.00%in the control group(P<0.05).Ovarian/uterine volume,follicular diameter,E_(2),FSH,LH,IGF-1 levels and BAI in the two groups significantly decreased after treatment compared with those before treatment,and the observation group was significantly lower than the control group(P<0.05).After treatment,NKB in the observation group was lower than that in the control group(P<0.05),while ADPN was higher than that in the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Zhibai Dihuang pill combined with leuprorelin acetate is safe and effective in the treatment of CPP in children,and can significantly inhibit the growth rate of bone age.The mechanism may be related to improving sex hormones,reducing serum NKB and increasing ADPN level.

关 键 词：儿童中枢性性早熟 知柏地黄丸 醋酸亮丙瑞林 神经激肽B 脂联素 

分 类 号：R725.8[医药卫生—儿科]